北京大学学报（医学版）2018，Vol.50Issue(1)：160-164,5.DOI:10.3969/j.issn.1671-167X.2018.01.027
内镜辅助导管改道术治疗唾液腺导管重度狭窄
Endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis
张亚琼 1叶欣 1柳登高 1赵雅宁 1谢晓艳 1俞光岩2
作者信息
- 1. 北京大学口腔医学院·口腔医院,医学影像科,口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081
- 2. 北京大学口腔医学院·口腔医院,口腔颌面外科 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081
- 折叠
摘要
Abstract
Objective: To evaluate the effects of endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis with concurrent megaducts. Methods: From Jul. 2010 to Dec. 2016,8 patients presenting with severe parotid duct stenosis and 3 patients with occlusion of the Wharton's duct underwent endoscopy-assisted sialodochoplasty. All these patients had concurrent severe ductal ectasiaand manifested a painful swelling of the involved salivary glands. The diameter of ectasia and length of stenosis of the sialoducts were measured preoperatively by sialography, computed tomography, or ultrasonography. The megaducts were opened transorally and sutured to the buccal or oral floor mucosa, therefore creating a neo-ostium. All the patients were followed up periodically after operation. The treatment effects were evaluated by clinical signs, sialogram and sialometry. Results: The length of the Stensen's duct stenosis was 5-12 mm, and the diameter of the concurrent ectasia was 8-16 mm. The length of the Wharton's duct stenosis was 10-20 mm, and the diameter of the concurrent ectasia was 6-8 mm. The neo-ostiums healed uneventfully 2 weeks after operation. The duration of the follow-up varied from 6 to 78 months (median: 24 months). Among the 8 patients with Stensen's duct stenosis, two experienced re-obliteration of the neo-ostium,but the buccal bulge and clinical symptoms disappeared; one reported recurrent clinical symptoms after initial alleviation,which could be controlled with self-massaging; the remaining 5 patients had satisfactory clinical results, i. e.,disappearance of the obstruction symptoms and buccal bulge, patent ostium, clean saliva and improvement of the ductal ectasia on sialogram. Three patients with Wharton's duct occlusion were asymptomatic with clear saliva and patent ostium; two exhibited approximately normal appearance and one showed improvement of the sialogram. Sialometry was performed in 9 patients with patent neo-ostium of the involved glands,the resting saliva flow rate of the affected glands showed no differences compared with the normal side, and stimulated flow rate showed a significant increase, though less than the control side. The clinical results included good in 5 patients, fair in 4 patients,and poor in 2 patients,with a total effective rate of 82％ (9/11). Conclusion: Endoscopy-assisted sialodochoplasty appears to be effective and can be a viable option for patients presenting with severe sialoducts tenosis and concurrent ectasia.关键词
腮腺/下颌下腺/导管狭窄/导管扩张/导管改道术/唾液腺内镜Key words
Parotid gland/Submandibular gland/Stenosis/Ectasia/Sialodochoplasty/Sialendoscopy分类
医药卫生引用本文复制引用
张亚琼,叶欣,柳登高,赵雅宁,谢晓艳,俞光岩..内镜辅助导管改道术治疗唾液腺导管重度狭窄[J].北京大学学报（医学版）,2018,50(1):160-164,5.
